Evidence map›Paper›PMID 34988767›Full record

ArticleBreast cancer research and treatment2022

Care in the time of COVID-19: impact on the diagnosis and treatment of breast cancer in a large, integrated health care system.

Annie Tang, Elad Neeman, Brooke Vuong, Vignesh A Arasu, Raymond Liu, Gillian E Kuehner, Alison C Savitz, Liisa L Lyon, Prachi Anshu, Samantha A Seaward and 8 more

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Breast cancer research and treatment, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed, 2 pooled it
3.2field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

20 citing papers in PubMed, 2 syntheses or guidelines pooled it, 31 citations in OpenAlex.

  1. Pooled it
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  8. Cancer management during the COVID-19 world pandemic.Cancer immunology, immunotherapy : CII · 2023
    Review
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  10. Impact on the Volume of Pathology Reports Before and During the COVID-19 Pandemic in SEER Cancer Registries.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2023
    Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors at 8 institutions in 1 country.

Annie TangDepartment of Surgery, University of California San Francisco, San Francisco, USA.
Elad NeemanDepartment of Medical Oncology, San Francisco Medical Center, Kaiser Permanente, San Francisco, USA.
Brooke VuongDepartment of Surgery, South Sacramento Medical Center, Kaiser Permanente, Sacramento, USA.
Vignesh A ArasuDepartment of Radiology, Kaiser Permanente Vallejo Medical Center, Vallejo, USA.
Raymond LiuDepartment of Medical Oncology, San Francisco Medical Center, Kaiser Permanente, San Francisco, USA.
Gillian E KuehnerDepartment of Surgery, Kaiser Permanente Vallejo Medical Center, Vallejo, USA.
Alison C SavitzDepartment of Surgery, Kaiser Permanente Walnut Creek Medical Center, Walnut Creek, USA.
Liisa L LyonDivision of Research, Kaiser Permanente Northern California, Oakland, USA.
Prachi AnshuDepartment of Surgery, Fremont Medical Center, Kaiser Permanente, Fremont Medical Center - 39400 Paseo Padre Pkwy, Fremont, CA, 94538, USA.
Samantha A SeawardDepartment of Radiation Oncology, Kaiser Permanente Oakland Medical Center, Oakland, USA.
Milan D PatelDepartment of Radiation Oncology, Kaiser Permanente South San Francisco Medical Center, South San Francisco, USA.
Laurel A HabelDivision of Research, Kaiser Permanente Northern California, Oakland, USA.
Lawrence H KushiDivision of Research, Kaiser Permanente Northern California, Oakland, USA.
Margaret MentakisDepartment of Surgery, South Sacramento Medical Center, Kaiser Permanente, Sacramento, USA.
Eva S ThomasDepartment of Medical Oncology, Kaiser Permanente Oakland Medical Center, Oakland, USA.
Tatjana KolevskaDepartment of Medical Oncology, Kaiser Permanente Vallejo Medical Center, Vallejo, USA.
Sharon B ChangDepartment of Surgery, Fremont Medical Center, Kaiser Permanente, Fremont Medical Center - 39400 Paseo Padre Pkwy, Fremont, CA, 94538, USA. sharon.b.chang@kp.org.ORCID http://orcid.org/0000-0001-7401-6177
Permanente Medical Group Breast Research Collaborative
Kaiser Permanente · USKaiser Permanente Vallejo Medical Center · USKaiser Permanente Oakland Medical Center · USKaiser Permanente South Sacramento Medical Center · USKaiser Permanente San Francisco Medical Center · USKaiser Permanente South San Francisco Medical Center · USKaiser Permanente Walnut Creek Medical Center · USUniversity of California, San Francisco · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposesTo delineate operational changes in Kaiser Permanente Northern California breast care and evaluate the impact of these changes during the initial COVID-19 Shelter-in-Place period (SiP, 3/17/20-5/17/20).

methodsBy extracting data from institutional databases and reviewing electronic medical charts, we compared clinical and treatment characteristics of breast cancer patients diagnosed 3/17/20-5/17/20 to those diagnosed 3/17/19-5/17/2019. Outcomes included time from biopsy to consultation and treatment. Comparisons were made using Chi-square or Wilcoxon rank-sum tests.

resultsFewer new breast cancers were diagnosed in 2020 during the SiP period than during a similar period in 2019 (n = 247 vs n = 703). A higher percentage presented with symptomatic disease in 2020 than 2019 (78% vs 37%, p < 0.001). Higher percentages of 2020 patients presented with grade 3 (37% vs 25%, p = 0.004) and triple-negative tumors (16% vs 10%, p = 0.04). A smaller percentage underwent surgery first in 2020 (71% vs 83%, p < 0.001) and a larger percentage had neoadjuvant chemotherapy (16% vs 11%, p < 0.001). Telehealth utilization increased from 0.8% in 2019 to 70.0% in 2020. Times to surgery and neoadjuvant chemotherapy were shorter in 2020 than 2019 (19 vs 26 days, p < 0.001, and 23 vs 28 days, p = 0.03, respectively).

conclusionsDuring SiP, fewer breast cancers were diagnosed than during a similar period in 2019, and a higher proportion presented with symptomatic disease. Early-stage breast cancer diagnoses decreased, while metastatic cancer diagnoses remained similar. Telehealth increased significantly, and times to treatment were shorter in 2020 than 2019. Our system continued to provide timely breast cancer treatment despite significant pandemic-driven disruption.

Indexed as

Breast NeoplasmsCOVID-19Delivery of Health Care, IntegratedFemaleHumansPandemicsSARS-CoV-2BreastCOVID-19PresentationTelehealthTreatment times

Identifiers

PMID34988767
PMCPMC8731186
OpenAlexW4206810707

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.